Projects & Impact

AHP has built its business on applying best practices, many of which we have helped to shape, and real-world, hands-on knowledge to improving systems and business practices for our clients.

In all of the work that we do, we are guided by our mission to improve health and human services systems of care and business operations to help organizations and individuals reach their full potential.

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ATR is an innovative program that helps people in Massachusetts who are in early recovery from an opioid use disorder (OUD) gain wider access to community services. ATR is making a difference: Overall, participants have seen a fourfold increase in employment after they complete the program, compared to when they enrolled. ATR graduates are better able to sustain recovery, find jobs, and maintain stable housing.

ATR participants choose the recovery support services they think will help them most. Options include care coordination, basic critical needs support (e.g., clothing, IDs), public transportation passes, health and mental health supports, and employment training. ATR gives participants the dignity of self-sufficiency and the hope for a future in sustained recovery.

This project is being implemented in four Massachusetts cities: Springfield, Boston, Worcester, and New Bedford.

For the relatively low cost of an average of $1,865 per participant for the 6-month program, ATR saves the Commonwealth money and, more importantly, saves lives. During one grant year alone, $4 million went back into the local economy by paying providers for the services offered to participants and by paying participants a work-study benefit when they attended job-training programs.

The key to ATR’s success is its focus on employment through job-readiness training, job search assistance, and occupational training. Job training is provided to participants with a recognition that they have complex needs and benefit from customized approaches to employment training. The ATR employment program, the Career Building Initiative (CBI), is a national model for successful job readiness and occupational training for people in early recovery from substance use disorders.

About 90 percent of ATR participants have some criminal justice system involvement and often face barriers to securing employment. To accommodate this population, CBI includes training in jobs that employ people with a criminal justice background, including culinary/food services, commercial cleaning, construction, hotel/hospitality, truck driving, and office work.

ATR coordinators are continuously trained on recovery planning, motivational interviewing, and engagement techniques, resulting in successful engagement with the participants throughout their time in the program.

Impact:
Since the ATR grant began in 2010, the program has provided services to more than 25,000 individuals in Massachusetts. Participants in the 6-month program have very low rates of overdose deaths while enrolled in the program (less than 1 percent), low rates of new arrests, and the following positive, statistically significant improvements:

Increased employment or school enrollment

Increase in stable housing

Increased abstinence from alcohol and other drugs

Substantially increased wages and a decreased reliance on public assistance

Decreased instances of re-incarceration

Participants in ATR’s Career Building Initiative (CBI) have even greater rates of employment or school enrollment than non-CBI participants after ATR involvement.

A state department of mental health has engaged AHP to deliver research and consulting services to improve business operations and impact systems of care through recruiting and retaining a high performance professional services workforce. AHP will provide guidelines for an optimal compensation and workforce development strategy to enable contracted provider agencies to effectively recruit and retain highly qualified behavioral health professionals to provide psychiatric services at inpatient and outpatient facilities statewide. Services include those provided to patients and clients by psychiatrists, other physicians, psychologists, and additional professional staff including “doctors on call” to ensure that a psychiatrist is onsite 24 hours per day, seven days per week, 365 days per year at every inpatient site.

Impact:
The ultimate goal is to develop a best practices compensation model to guide organizational change to a new trauma-informed, person-centered culture of care that incorporates high-performance business practices.

BHbusiness Plus was funded through SAMHSA. Utilizing a coached learning network model that lasted 3 to 6 months per network, AHP conducted more than 50 learning networks, each involving hundreds of participants, around the following topics:

Value-based Purchasing

Bundled Payments

Data-Driven Decision Making

New Business Planning

Costing Out Your Services

Setting up a Third-Party Billing System

Improving Your Third-Party Billing System

Third-Party Contract Negotiations

Eligibility and Enrollment

Strategic Business Decision Making

Planning for the Next Generation of HIT

Exploring Affiliations, Mergers, and Acquisitions

The goal was to help behavioral health providers identify and implement customized change projects that expanded their service capacity, harnessed new payer sources, and ultimately made them able to thrive in the changing health care environment. The program empowered participating organizations to actually make quantifiable changes, rather than just learn how to do so. It linked participants into specific learning networks that focused on a specific topic of interest and provided opportunities for networking and peer support.

Everyone within individual learning networks received hands-on expertise and guidance to initiate, continue, and complete business operations changes.

Currently, BHBusiness offers virtual technical assistance through self-paced online courses, coupled with a robust library of web resources on these same topics, at no cost to participants.

Thousands of behavioral health provider organizations across the nation have participated in BHbusiness, gaining the knowledge to make and, in many cases, implement significant changes to improve business operations.

Facing evolving state and federal requirements for clinical integration, this group of rural behavioral health providers sought AHP’s help to assess their capabilities and begin to build a provider network to better serve their region. Recognizing the competitive risk of more dominant health systems, these smaller providers have banded together and are collaborating with AHP to strengthen their administrative capacity and efficiency and deliver care more effectively. AHP is conducting a readiness assessment of each provider’s capabilities for forming a provider network model with an analysis of strengths and weaknesses, along with recommendations for the most suitable network model to pursue. In addition, AHP is developing a business planning process with a blueprint for implementation for the chosen model. Each organization will receive a feasibility study and business plan for establishing a shared services organization.

Impact:
Ultimately this work will strengthen all participating community-based behavioral health service agencies involved by creating business operation efficiencies, building a network of shared services, and improving the quality, access, and delivery of behavioral health care to the residents of the rural counties affected.

The Colorado Office of Behavioral Health (OBH) selected a team led by Western Interstate Commission for Higher Education (WICHE) Mental Health Program to conduct a needs analysis and scan of existing and promising behavioral health models. AHP worked with the WICHE team, which included NASMHPD Research Institute (NRI), to complete 17 tasks. AHP assessed:

Olmstead v. L.C. legal decision considerations in the provision of state psychiatric beds;

integration of behavioral health and physical health care;

impact of marijuana legalization and prescription drug misuse on CO OBH service needs;

impact of state drug sentencing reform on CO OBH service needs; and

state approaches to support employment and housing for mental health consumers.

The work on tasks included a literature review, environmental scan, key informant interviews, focus groups, and analysis of existing state-level data. A report was prepared for each task and combined into a comprehensive report that included recommendations for Colorado’s OBH.

Members of an intellectual/developmental disabilities (I/DD) providers association engaged AHP to help form a management service organization (MSO) in response to imminent changes in the regulatory and business environment driven by the Affordable Care Act. AHP conducted a readiness assessment and then developed an implementation plan and roadmap to guide the group of providers toward establishing the MSO to re-engineer care delivery systems and adopt integrated service solutions and new technology. The comprehensive roadmap outlined the functional processes to put in place and a set of recommendations and procedures to help launch the MSO for the providers.

Agency:
Association of service providers to individuals with intellectual/developmental disabilities

Impact:
As a result of AHP’s work, the providers are continuing down the road of creating an MSO, with the goal of reducing costs and maintaining quality. Ultimately, the provider association plans to use the model and roadmap to inspire a series of MSOs among their extended membership, strengthening business capacity and the ability to deliver care throughout the region.

This provider association engaged AHP to help form a provider network from among its members. AHP developed a robust strategic business operational plan and pro forma by performing in-depth analyses of key business operations areas and developing an action plan. Building on that work, AHP then facilitated the implementation planning process for credentialing and billing. As a result, AHP delivered a comprehensive roadmap outlining the functional processes to institute and a set of recommendations and procedures to help launch the desired network.

AHP is the evaluator for a Massachusetts Department of Public Health, Bureau of Substance Abuse Services (BSAS) grant to expand medical and behavioral health service systems capacity to engage and retain pregnant and postpartum women in integrated medication assisted treatment (MAT) and health care, and addiction and recovery support services. Funded through the Substance Abuse and Mental Health Services Administration’s (SAMHSA) targeted capacity expansion portfolio, The Moms Do Care Project is being implemented in two communities (one rural and one urban) and focuses on the specific needs of pregnant women with opioid use disorders. Its overarching objective is to provide recovering mothers with increased access to MAT and with individualized services that support sustained recovery, choices about continuing medication, and efforts to maintain custody or contact with their children.

Expected outcomes include increased access and engagement in MAT concurrent with pre-and post-natal care; reduced illicit drug use; and improved health, recovery, and functioning status at the individual level. Systems level outcomes include an increased number of waivered buprenorphine prescribers; increased workforce understanding of opioid dependency in women specific to the needs of pregnant women; reduced negative attitudes of this population among medical providers; and improved integration of primary care and behavioral health services. AHP will assess outcomes through client interviews at three points in time, administrative treatment data, surveys of medical providers, and onsite visits with a range of key informants.

Impact:
The evaluation should provide critical information on implementing this type of complex intervention, as well as its impact at the client and system levels. As a new approach to engaging and serving a population of pregnant opioid-using women, the evaluation findings will help shape program development over time and help determine which components are most promising for which types of women.

AHP serves as the evaluator for a Center for Substance Abuse Prevention (CSAP) HIV Capacity Building Initiative (HIV CBI), Project Aspire. The goal of the grant is to prevent and reduce the onset of substance misuse and transmission of HIV/AIDS among at-risk racial/ethnic minority youth and young adults.

Equinox, a multiservice nonprofit organization, will provide evidence-based substance use disorder (SUD) and HIV/Viral Hepatitis (VH) prevention programming, onsite HIV/VH testing, and substance misuse assessment and counseling services to at-risk minority youth in Albany, NY, through its Youth Outreach Center. Peer Youth Leaders will promote engagement and co-facilitate prevention activities including the Say It Straight intervention. AHP will conduct a community needs assessment and assess program performance by documenting and measuring client outcomes and conducting a process evaluation. The needs assessment will include a review of epidemiological data, including prevalence rates, service gaps and disparities, community readiness to change, and capacity to provide SUD, HIV, and VH prevention and treatment services.

Agency:
Center for Substance Abuse Prevention (CSAP)

Project Director:
Jeanine Hanna, Ph.D.

Impact:
All data will be used to support ongoing monitoring and evaluation of the project and inform and improve system-level activities.

Since 2005, AHP has helped nearly all Massachusetts FQHCs and others in the Northeast and Mid-Atlantic to re-engineer key operational and clinical processes. AHP delivers value to the bottom line through evaluating and improving process mapping and workflow analysis, EHR implementation, identification of barriers and constraints, clinical and operational staff training, and system validation. AHP experts help FQHCs to integrate primary care and behavioral health, conduct strategic planning to meet the requirements of health care reform, and perform protected health information privacy and security assessments. Since 2011, AHP has assisted FQHCs in meeting the Centers for Medicare and Medicaid Meaningful Use.

Impact:
As a result of AHP’s work, many clients have successfully met the Meaningful Use Stage 1 requirements and are in process with Stage 2, receiving hundreds of thousands of dollars in Meaningful Use incentives. AHP’s expertise with FQHCs has led to additional contracts, including Uniform Data Systems for Health Centers.

For the National Institute for Disability, Independent Living, and Rehabilitation Research (HHS), under Grant 90IF0098-01-00, AHP will conduct a study examining the comparative effectiveness of Intentional Peer Support (IPS) in improving community living and participation for adults with psychiatric disabilities. IPS is a peer-developed, theoretically based, manualized approach that is unique in conceptualizing peer support as a relationship-based learning process in the context of personal growth and community-building. The study will compare the outcomes of IPS with those of standard peer support services on dimensions including self-esteem, self-discrimination, social connectedness, community participation, and quality of life.

Agency:
National Institute for Disability, Independent Living, and Rehabilitation Research

Impact:
The results of this first-ever quasi-experimental study of Intentional Peer Support will provide important information on how an innovative model of peer support may enhance community living and integration for adults with psychiatric disabilities.

AHP helped to assess and improve key business operations for The Resource Center, a provider of intellectual/developmental disability, primary care, dental, and mental health services in New York State that was facing financial challenges under health care reform. Over a two-year period, AHP conducted a claims analysis and a productivity study, as follows:

The analysis identified the causes of financial losses, gaps in the revenue management process, and opportunities for improved pricing strategies and contract negotiation processes.

The productivity study analyzed the clinical workflow and its impact on revenue models, revealing both the need to improve productivity and to increase patients to the practice. AHP’s recommendations from all phases of work were quickly implemented by the client. Today operations are more efficient, productive, and profitable.

AHP is collaborating with the Illinois Institute of Technology (IIT) to develop, implement and pilot-test an integrated behavioral health and primary care intervention for homeless African Americans with mental illness. Funded by the National Institute of Minority Health and Health Disparities, in this project, peer navigators—African Americans with lived experience of homelessness and behavioral health problems—connect homeless African Americans with mental illness to medical and mental health care, helping them “navigate” these complicated health systems. AHP and IIT are conducting a randomized controlled clinical trial examining the effectiveness of peer navigators in improving health outcomes for this vulnerable population.

Impact:
Preliminary results suggest that project participants who worked with peer navigators had significant improvements in health functioning. Peer navigators may be a critical tool in helping homeless African Americans with mental illness access the integrated behavioral health and primary care services they need to address their complex health problems.

For this project funded by the Substance Abuse and Mental Health Services Administration (SAMHSA), AHP designed and implemented a six-year process and outcome evaluation of 13 grantees, mounting innovative, multilevel state and pilot programs that provided trauma-informed services and supports to veterans involved in the criminal justice system. The goal of the evaluation was to document the implementation of state and local pilot activities by grantees and understand the impact of the pilot program services on client outcomes, in particular behavioral health and recidivism. The key sources of data for the process evaluation include the bi-annual collection of standardized semi-structured reports and two face-to-face site visits. The key sources of data for the client outcomes evaluation include longitudinal in-person interviews and data collected through secondary sources on arrests and services at all 13 sites.

Impact:
The evaluation yielded high quality information that helped inform technical assistance to grantees, as well as provide SAMHSA and the field with information on the key components to implementing state and pilot level programs, and impact of program services on client outcomes.

AHP was a subcontractor to SAMHSA’s National Center for Trauma-Informed Care and Alternatives to Restraint and Seclusion (NCTIC) for 8 years. A diverse team of staff and consultants, many of them trauma survivors and nationally recognized leaders, provided technical assistance (TA) and participated in developing products and materials under this contract. The National Association of State Mental Health Program Directors (NASMHPD) was the prime contractor for NCTIC.

NCTIC supported SAMHSA’s commitment to provide information, technical assistance, and support to increase awareness about the impact of trauma on people with mental health or substance use disorders, as well as people served by public health, education, and corrections systems.

A key focus of the work was to promote alternatives to seclusion, restraint, and other coercive interventions to minimize the likelihood of re-traumatization. The use of trauma-informed approaches was incorporated into a broad range of service systems, with input from trauma survivors’ perspectives in all aspects of the contract.

NCTIC was guided by the fundamental beliefs that people with personal experiences of trauma can and do recover and heal; trauma-informed care is the hallmark of effective programs to promote recovery and healing through support from peers, consumers, survivors, ex-patients, and recovering persons and mentoring by providers; and leadership teams of peers and providers charting the course for the implementation of trauma-informed care are essential.

As one of the earliest national organizations to recognize the importance of trauma, NCTIC is proud of its contributions to establishing trauma-informed care as a powerful social movement involving agencies, communities, and states across the country. Its work with federal partners and trauma survivors fueled a deeper understanding of how best to meet the needs of individuals who have experienced trauma.

Work included:

A blog series titled From Trauma-Aware to Trauma-Informed: Implementing SAMHSA’s Six Principles

Three virtual learning networks

Three webinar series

Training curricula on trauma-informed care for all service settings, and trauma-informed services for people living with HIV (PLHIV)

The project made major strides in addressing SAMHSA’s Trauma and Justice Strategic Initiative goals of creating capacity and systems change in the behavioral health and justice systems; implementing trauma-informed approaches throughout health, behavioral health, and related systems; and reducing the impact of disasters on the behavioral health of individuals, families, and communities. It touched every possible service arena—from individual to community, state, and national efforts.

Major accomplishments of the project included the administration of more than 1,000 technical assistance events between 2013 and 2018, reaching approximately 10,000 individuals between on-site events, webinars, virtual learning networks (VLNs), and consultation. In addition, specialized TA was provided in Baltimore, MD, to stakeholders from 76 different agencies following major unrest in that city after a teen died while in police custody.

AHP, in collaboration with Carnevale Associates, received Small Business Innovation Research contracts from NIDA to develop and support the DDRS. The project was initiated because current enforcement approaches—originally developed to reduce drunk driving—are not adequate for dealing with the problem of drugged driving. In addition, there is not enough data collected about drugged driving at the local, state, or national level to fully inform policy and programs.

The DDRS team worked with an expert panel of nationally recognized researchers to agree on a National Minimum Data Set (NMDS) on Drugged Driving to meet the federal government’s need for data, understand the magnitude of the problem of drugged driving, and identify possible prevention strategies to benefit public health. Based on this work, AHP designed the Drugged Driving Survey, an anonymous online survey designed to collect data elements outlined in the NMDS.

Using the survey, AHP partners with states for data collection activities. Each state recruits participants through its department of motor vehicles. AHP assists states and localities with data collection and publicizing the online survey and provides technical assistance and support to develop a sampling approach and recruitment strategy. Moving forward, states can use this data to help define the scope of the problem and provide critical information that will allow them to target resources for prevention and enforcement.

Impact:
The project will produce significant and long-ranging benefits for participating states. Benefits include data that reveal the incidence of drugged driving, data defining the scope of the problem, and data that support the development of resources for prevention and enforcement.

The National Veterans Technical Assistance Center (NVTAC) was a partnership among AHP, the National Coalition for Homeless Veterans, and the U.S. Department of Labor’s Veterans Employment and Training Services. Led by AHP and funded under a cooperative agreement for four years, the NVTAC supported the mission of the Homeless Veterans Reintegration Program (HVRP) and its stakeholders. We assembled a cadre of experts knowledgeable about veteran homelessness, workforce development, and adult learning that included veterans committed to helping their service member colleagues.

We tapped the experience of practitioners in the field by facilitating peer-to-peer learning in our national virtual learning community; spotlighting individual grantees and their staff to inform the field and through regional face-to-face events. AHP worked with grantees and convened experts to establish 10 best-practice elements showcased on the NVTAC website and supported implementation through webinars and training.

Our work was responsive to our client’s needs. When Hurricane Harvey hit the Gulf Coast, we reached out to grantees with resources and established a go-to website for community recovery. When direct service staff needed to build their skills, but grantee organizations could not afford to send staff to training sites, we developed online, instructor-led courses. As more communities wanted to host veteran stand-down events and DOL sought to support these, AHP prepared materials and a website to ease the challenge of organizing an event.

We measured learning impacts. Following training, we not only asked if participants were satisfied, we also asked about what they learned and if their participation led to changes in their behavior, practice, or policy.

Through NVTAC, AHP quickly became the go-to source for a broad range of technical assistance, training, and policy advice on veterans’ homelessness programs and issues to existing and potential audiences. This has been done through:

developing, conducting, and documenting extensive outreach efforts to national, state, and local employers to increase their awareness of HVRP, HFVVWF, IVTP, and SD in order to increase employment and training opportunities for veterans experiencing or at risk of homelessness;

identifying, extracting, documenting, and sharing best practices or other case-study-oriented overviews, as defined and directed by VETS;

assisting VETS leadership by suggesting and conducting research and program improvement-based studies, as ultimately defined and directed by VETS; and

providing consulting to an external national evaluation of the HVRP.

Among the major accomplishments in this project, AHP developed remote service-informed technical assistance and research-driven virtual training to grantees in settings ranging from urban to rural across the nation, serving women veterans, incarcerated veterans, veterans in families, Native American veterans, and single male veterans. Training topics included improving employment outcomes to justice-involved veterans, approaches to job-driven training, and meeting the needs of veterans with behavioral health and other challenges. In addition, NVTAC has provided onsite grantee-specific assistance to improve program operations, integrate use of best practices, and achieve desired outcomes in the Boston, Philadelphia, Atlanta, Chicago, Dallas, and San Francisco regions. NVTAC developed a number of electronic and print materials, including brief video interviews with experienced grantees, briefing papers, research results, website updates, and a self-paced elearning course on job retention for veterans.

Impact:
A wide range of grantees across the United States increased their knowledge and skills through virtual and onsite technical assistance and training on topics from employment outcomes to justice-involved veterans, supported by extensive information and materials, including how-to-do-it practices.

AHP developed a strategic plan for this nonprofit provider of services for individuals with HIV/AIDS, focused on new products and services arising from health care reform opportunities, specifically guiding the organization in expanding its services to managed care organizations (MCOs). Once in place, the plan laid a foundation for AHP to help the client develop proposals to solicit contracts for specialized managed care services to the HIV/AIDS and other vulnerable populations. These proposals were submitted to major managed care insurers with plans targeting the Medicaid long term care services markets.

Inspira Health Network, an accountable care organization (ACO) with three medical centers and more than 100 access points, sought AHP’s help to make rapid, well-informed decisions about the best allocation of its behavioral health resources and facilities to best serve the surrounding community and deliver value to the bottom line. The goal was to research and deliver a position paper for presentation to legislative, business, and community stakeholders that would encourage support for the ACO’s proposed facility and product expansion. In a very tight timeframe, AHP conducted an assessment of the existing and future business environment, researched and defined the product line and proposed expansion, and developed a paper positioning Inspira Health Network and the benefits proposed for the community.

Impact:
AHP’s final report exceeded the client’s expectations. The ACO leadership was able to provide a highly professional presentation to key stakeholders and advance its business goals for product and facility expansion. Should the plan receive official approval, the health system will build and enhance its behavioral health services delivery.

From 2014 to 2018, under a contract with SAMHSA, AHP led the Recovery to Practice (RTP) workforce initiative to expand and integrate recovery-oriented care delivered by behavioral health providers across systems and service settings. The purpose of the RTP project was to help SAMHSA promote and support person-centered, recovery-oriented principles and practices as integral to multidisciplinary treatment and services for people diagnosed with serious mental illnesses and/or substance use disorders.

Primarily a workforce development project, RTP helped improve and supplement the skills and competence of practitioners across disciplines—including physicians and other medical personnel, therapists and social workers, and peer specialists and those who provide support services. Through RTP, SAMHSA built a comprehensive suite of online educational resources for understanding, providing, and improving recovery-oriented services.

RTP addressed applications and recovery-oriented practices within multidisciplinary services and integrated settings. As part of the contract, the RTP team

Redeveloped and expanded SAMHSA’s RTP website

Created quarterly newsletters and other resources

Provided technical assistance and educational events to help promote and support recovery-oriented approaches in integrated and multidisciplinary settings

Created new training modules on interdisciplinary service approaches and homelessness

Developed decision support resources for clinicians

AHP hosted a series of 48 multifaceted, multidisciplinary, far-reaching education programs consisting of continuing education unit (CEU)–approved webinars and a resource-rich companion newsletter on a variety of recovery-oriented topics, including homelessness and housing instability, engagement, recovery-oriented approaches to medication, and recovery-oriented cognitive therapy (CT-R). Participants gave these webinars an overall effectiveness rating of 98 percent.

In addition to webinars, AHP created two SAMHSA-approved multi-module virtual learning courses: Integrated Practice in Primary and Behavioral Health, and Information for Peer Specialists Working with People Experiencing Homelessness.

AHP also completed a robust set of CEU-carrying clinical decision support materials for physicians and other practitioners. The virtual courses blended evidence-based medicine with a recovery orientation and focused on recovery-oriented prescribing practices, co-occurring disorders, and clozapine. Mindful of the needs of this professional audience, AHP developed six podcasts that focused on complex clinical considerations around psychotropic medication, including recovery-oriented approaches to prescribing, choosing the right medication at the right time, prescribing multiple medications, treating pregnant women, the intersection of serious mental illness and chronic pain, and prescribing long-acting injectable medications.

AHP created educational materials that reached more than 12,000 professionals across a wide range of disciplines. More than 4,500 individuals registered for the 12 virtual technical assistance events that took place in 2018, representing 49 states and the District of Columbia. Also in 2018, nearly 8,000 more people viewed archived recordings of those webinars on YouTube. Overall, Recovery to Practice (RTP) developed 48 webinars that continue to draw interest and web traffic. As a result of AHP’s work, RTP awarded nearly 1,100 continuing education certificates.

In 2011, AHP foresaw the coming impact of both the Mental Health Parity and Addiction Equity Act (MHPAEA) and the Affordable Care Act (ACA) on the substance use disorder (SUD) field. Working with the State Associations of Addictions Services (SAAS), the largest national association of SUD treatment and service providers at the time, AHP developed an approach to assess and redesign the nation’s SUD delivery system. Together SAAS and AHP deployed the Readiness and Capabilities Assessment (RCA), a jointly developed survey tool to measure provider ability to meet the expected demands of the new legislation.

Impact:
AHP produced a white paper presenting a systems change approach for SUD providers to use in adapting and transforming to the requirements of the MHPAEA and the ACA with their demands for behavioral/mental health parity and the triple aim of quality, cost, and care. The report was widely disseminated among industry, provider, and legislative stakeholders.

AHP is working with the Los Angeles County Department of Public Health Substance Abuse Prevention and Control (SAPC) to support the county in developing a state-required plan to opt into the Drug Medi-Cal Organized Delivery System (DMC-ODS) Waiver for adult and adolescent populations. The waiver expands treatment and recovery services and creates a continuum of care for individuals diagnosed with a substance use disorder (SUD).

In partnership with the SAPC leadership and other key stakeholders, AHP is developing the financing formula and the organizational and staffing infrastructure that will support the DMC-ODS. To fully develop the architecture and financing recommendations, AHP is analyzing similar systems, studying rate setting methodologies, providing comprehensive data analysis, evaluating financial formulas, cross-walking ASAM levels of care with standardized code sets, and gathering information on managed care financial operations. AHP will also provide recommendations for a cost-effective training plan to develop the staffing capabilities and readiness for implementation of the new system.

Agency:
Los Angeles County Department of Public Health Substance Abuse Prevention and Control (SAPC)

Impact:
This project is the first of its kind in California and is of interest to many other states considering similar waiver programs. Success will be measured by the establishment of a continuum of care for SUD treatment and recovery services that integrates all revenue streams into a single benefit package, along with a final, negotiated SUD specialty health plan (per user per month) financial rate with the state.

AHP has been awarded a grant by the National Institute of Justice (NIJ) to conduct a study of the treatment and aftercare services provided under the Bureau of Justice Assistance (BJA) Residential Substance Abuse Treatment (RSAT) Program. The goal of the RSAT Study is to provide NIJ with programmatic knowledge about BJA RSAT-funded treatment and aftercare services. Using a mixed methods design, the study will focus on describing the range and types of substance use treatment, re-entry/release planning activities, and related aftercare services that are provided to offenders through the BJA RSAT program. In particular, the evaluation seeks to identify the application and penetration of evidence-based principles and practices in facilities (jail, prison, juvenile detention) and post-facility with RSAT funds.

Impact:
The study will provide information on the BJA RSAT funded treatment and aftercare services that will both fulfill its legislative mandate under the Second Chance Act to provide a report to Congress and fill an existing knowledge gap that will provide a foundation for supporting BJA programs.

Rosecrance Health Networks, a private, not-for-profit behavioral health organization, contracted AHP to analyze its residential treatment data in order to help Rosecrance highlight how its services help adolescents and adults struggling with substance use disorders recover and reclaim their lives. Working with Rosecrance leadership, AHP identified the most compelling information on patient recovery and program success, and made recommendations on how Rosecrance might use those results in marketing its services. As part of this process, AHP examined how Rosecrance meets national and state quality indicators of effective substance use treatment.

SAMHSA contracted with AHP to provide training and technical assistance (TA) on housing and homelessness to SAMHSA Homeless Program Branch (HPB) grantees and other homelessness housing and service providers operating across the United States and U.S. territories. Housing and service programs are united by a vision of ending homelessness by supporting individuals through a process of change as they improve their health and wellness, live a self-directed life, and strive to reach their full potential.

The goals of this project include the following:

Promoting the adoption of best practices for serving people who are experiencing homelessness or are at risk of becoming homeless and have chronic mental illness or co-occurring disorders;

Increasing workforce capacity through TA and training;

Disseminating information to the homelessness services field in support of SAMHSA’s strategic initiatives;

Collaborating with other agencies and organizations to improve the coordination of SAMHSA activities focused on addressing homelessness and building effective partnerships; and

Measuring meaningful change.

The HHRN TA team is led by AHP and includes partners HomeBase, Policy Research Associates (PRA), JBS International, the National Association of State Mental Health Program Directors (NASMHPD), and Abt Associates.

Through AHP's team, HHRN provides assistance to the public and to HPB grantees, which includes PATH, Cooperative Agreements to Benefit Homeless Individuals (CABHI), and Grants for the Benefit of Homeless Individuals (GBHI) grantees that touch people in every state and territory. HHRN serves as the TA and training resource for SAMHSA.

AHP has supported long-time client and partner, the Illinois Alcoholism and Drug Dependence Association (IADDA), on several key policy, marketing, and system design initiatives. In 2012, AHP reviewed and analyzed state insurance laws and regulations, and made recommendations concerning substance use disorder (SUD) policy and coverage. Subsequently, in light of Illinois’ decision to expand Medicaid in a coordinated care organization context in 2013–2014, AHP conducted an environmental scan to identify gaps in the statewide system of care that, if filled adequately, would result in an “ideal system design.” In 2014, AHP provided a review and set of recommendations for cost rates of behavioral health services in Illinois. The resulting document showed current rates were under national norms, and the data was used by IADDA in lobbying efforts to adjust provider rates in the state.

Impact:
AHP’s work with IADDA has empowered the organization to advocate on behalf of SUD and mental health providers in Illinois with key policy and regulatory stakeholders in the state and to influence positive change in the delivery of services.

AHP worked with this national association and its affiliate members around the country on a range of projects including re-engineering services and delivery systems in response to the requirements and opportunities under the Affordable Care Act. AHP has worked extensively with the national headquarters of the association to identify opportunities for affiliates, including identifying partnerships with health homes and accountable care organizations, exploring new business opportunities, and expanding publicly funded services into the private pay and third party/managed care markets.

The WCF project supported SAMHSA’s advancement of state-of-the-art knowledge around substance use and mental health needs of women and families through supporting leaders, workforce development efforts, product development, and expert consultation. The project utilized a multipronged approach to increase the field’s capability for meeting the needs of women, adolescent girls, and families across the nation, which included working with policy makers, providers, and leaders committed to improving women’s services throughout the nation.

AHP also provided expert consultation on gender-responsive prevention, intervention, treatment, and recovery support services for adolescent girls, pregnant women, and families with children.

AHP provided training and technical assistance through the WCF project from 2008 to 2018. AHP provided subject matter expertise and consultation to SAMHSA, NASADAD, states and community groups on effective interventions, treatment and recovery support for women and families.

Key project components included:

National conferences

Webinars, trainings, and online courses

Research; internal and external reports

Expert panels

Support for the National Association of State Alcohol/Drug Abuse Directors (NASADAD)/Women’s Services Network

Creating the Women’s Addiction Services Leadership Institute (WASLI) and administering it six times. WASLI was a competitive, application-based, 6-month leadership program. A total of 112 associates and 56 coaches participated over the six cohorts, with a 100 percent graduation rate. Evaluations from the final WASLI class showed 100 percent of associates felt WASLI had a large impact on their leadership skills; 70 percent had increased workplace responsibility since WASLI, which is particularly notable considering this WASLI class had just graduated when they took the survey.

Over several contracts, AHP has conducted studies, provided analysis and technical advice, written papers and Reports to Congress, and reviewed CMHS business operations. In addition, AHP writers are the principal speech and blog writers for the CMHS Office of the Director. Speeches and blogs communicate SAMHSA’s vision, mission, and priorities as they relate to the development of a person-centered, recovery-focused, evidence-based, and quality-driven system of behavioral health care. Speeches are prepared for national meetings and conventions, state and community organizations, national and international policymaking groups, and congressional committees.

AHP’s accomplishments in support of the CMHS Office of the Director are both broad and deep. For example, AHP:

Wrote Reports to Congress on borderline personality disorder and certified community behavioral health clinics;

Provided insight into the evolving research and policy surrounding the social determinants of mental health;

Helped assess the evidence base for the effectiveness of selected behavioral health treatments;

Examined states’ priorities vis-a-vis health reform;

Reviewed crisis support programs for people with behavioral health conditions;

Examined employment of individuals with behavioral health disorders who have criminal justice involvement;

Conducted an examination of patient activation for behavioral health;

Developed CMHS program profiles;

Helped develop materials related to the prevention of mental, emotional, and behavioral disorders;

Examined the relationship of maternal health and child behavioral health outcomes; and

Analyzed the extent to which the landmark Supreme Court decision in Olmstead v. L.C. is working for Americans with disabilities, including those with mental and substance use disorders.

Impact:
AHP helps SAMHSA articulate its mission, vision, and values to ensure that SAMHSA remains at the forefront of efforts to create person-centered, recovery-focused, evidence-based, and quality-driven services for people with mental health and substance use conditions.

The Substance Abuse and Mental Health Services Administration (SAMHSA) contracted with AHP to manage this national technical assistance (TA) and training center, which provided services to CSAP and CSAT grantees funded through the Minority AIDS Initiative (MAI).

Through onsite and innovative virtual TA, BH-HIVTAC provided high-quality services, fostered an understanding of the people the program served, and supported development of integrated services that were culturally and linguistically appropriate for these priority populations and their communities. The goal of this TA and training was to increase capacity for local behavioral health provider networks to develop and expand their substance use prevention and treatment services, particularly those integrating HIV and viral hepatitis prevention services and linkages to primary health care.

BH-HIVTAC reached more than 1,500 participants through its virtual conferences for grantees. The highly interactive sessions focused on topics ranging from using social media to recruiting youth and young adults at risk of HIV into substance use prevention and treatment services and integrating peer recovery services into workforce development in behavioral health programs.

In addition, BH-HIVTAC held collaborative webinars and intensive onsite training and TA. It hosted small virtual learning networks designed to strengthen and support grantee effectiveness and facilitated development of regional grantee networks to promote grantee-to-grantee connections to build local grantee capacity.

AHP held three innovative virtual 2-day grantee conferences designed by AHP staff. The 2018 Center for Substance Abuse Treatment (CSAT) grantee virtual conference had more than 350 attendees, with plenary and keynote sessions, three tracks (clinical, program administration, and evaluation) and a virtual poster session with presentations by 10 grantees. More than 600 people attended a joint 2016 Center for Substance Abuse Prevention (CSAP)/CSAT virtual conference, which had plenary and keynote sessions and three tracks. The 2015 CSAP grantees conference had plenaries, concurrent sessions, and two grantee panels, with a total of 300 attendees.

The BH-HIVTAC contract provided 178 site visits, 65 webinars, and engaged 47 subject matter experts (SMEs) for 450 grantees over a 4-year period. Site visits took place in 24 states/territories.

AHP received a grant from the Office of Women’s Health (OWH) to research, revise, and then implement a pilot cross-training program for community domestic violence and HIV/AIDS agencies in four cities across the United States to enhance their services to vulnerable, abused women who were either infected or at risk for HIV/AIDS. By educating each agency on the subject matter of the other agency and encouraging collaboration between them, AHP’s goal was to ensure that no matter how the woman entered the system for services, whether through the domestic violence or HIV/AIDS door, both issues would be addressed. After recruiting the requisite service agencies in cities in four states, revising the five-part curriculum and developing presentations, AHP conducted web-based and onsite trainings, including joint sessions with both agencies. The project included a final report that will empower OWH to roll out a national training program.

Impact:
Participant feedback was very encouraging, as exemplified in the following typical comment: “This training and the ability to talk to staff from the other agency really demonstrated the intersection between serving people with HIV/AIDS and DV survivors.”

AHP is supporting this provider association in its goal of establishing a long-term Medicaid managed care model for its member organizations that deliver services to individuals with physical disabilities. The managed care model will ensure care coordination between patient primary and mental health services, as well as facilitate their ability to live and work in integrated settings. In addition, the work explores network provider models to create a shared organizational infrastructure that will produce administrative and information technology efficiencies for the new managed care model. AHP is currently conducting readiness assessments and providing recommendations for best practices and models that best fit the organizations while meeting state regulatory requirements.

Agency:
Association of service providers to individuals with physical disabilities

Impact:
The project will develop a model for comprehensive, conflict free case management to integrate services while maximizing the potential for individuals to have choice in services in the most integrated settings.

AHP, in partnership with John Snow, Inc. (JSI), supports the Department of Health and Human Services (HHS) Health Resources and Services Administration’s (HRSA) Bureau of Primary Health Care (BPHC) in the continual development and improvement of processes, documentation, and technical assistance supporting the annual collection of BPHC and BHPr (Bureau of Health Professionals) Uniform Data System (UDS) program performance data from grantees.

The UDS is a core set of information used for reviewing the operation and performance of the approximately 1,300 health centers (Section 330 Federally-qualified Health Centers [FQHCs]), FQHC Look-Alikes (LALs) and Bureau of Health Workforce (BHW) Primary Care Clinics) nationwide, which tracks information about patient demographics, services provided, staffing, clinical indicators, utilization rates, and financial measures.

Project goals include ensuring the reliability and validity of UDS data by providing training, technical support and UDS reviewer expertise; collaborating with HRSA Electronic Handbook (EHB) system developers to enhance reporting tools and develop various standardized reports; and conducting analyses and developing reports useful to health centers (for program management and performance improvement), project officers (for monitoring and technical assistance), and to HRSA for analyzing the individual and collective impact of health centers in providing primary health care services to the nation’s underserved populations.

Impact:
AHP’s activities help ensure that the nation’s health centers continually provide complete, accurate, and measurable data on their ongoing activities, including an ever-expanding array of critical key clinical performance measures associated with long-term positive physical and behavioral health outcomes. HRSA’s Health Center Program Quality Improvements initiatives are aligned with AHRQ National Quality Strategy aims of providing better and more affordable care for individuals and communities in underserved populations throughout the United States.